[Shunt patency after creation of a transjugular intrahepatic portosystemic shunt: evaluation with Doppler ultrasound].

TIPS (transjugular intrahepatic portosystemic shunt) is a new interventional radiologic procedure that is useful in the treatment of variceal bleeding and ascites due to portal hypertension. It is most important that the shunt remains patent for a long time after placement. The potential role of ultrasound in evaluating the patency of the shunt after TIPS has been studied. Duplex and color doppler sonography were performed in 20 patients with portal hypertension after TIPS. Imaging was done in 38 case. The findings were compared with those of follow-up angiography. Shunt patency was evaluated with Doppler US in 28 case. In 27 of them, the equivalent patent shunt was confirmed by angiography; the exception was one case of occlusion in follow-up angiography. Doppler signals in the shunt could not be detected in 10 cases. Follow-up angiography showed occlusion in 7 cases and patency in the other 3. Doppler US sensitivity was 90%, and its specificity was 88%. These results indicate that Doppler US is one of the most useful methods for evaluating shunt patency after TIPS.